The NICE clinical guideline on the epilepsies (CG137) recommends that IV lorazepam be administered as first-line treatment in hospital in children, young people and adults with ongoing generalised tonic–clonic seizures (convulsive status epilepticus), with IV diazepam as an alternative if this is unavailable (or buccal midazolam if immediate intravenous access cannot be secured).
The full guideline notes that there was no significant difference found between IV lorazepam and IV diazepam in the evidence (although this is stated to be of low quality). Lorazepam has the advantage over other antiepileptic drugs in its faster onset of action and longer half-life, and consequently patients need fewer additional rescue drugs. However there have been issues with its availability and in this instance the opinion of the Guideline Development Group was that IV diazepam would be a suitable alternative.